Determinants_of_Health

Determinants of health contributing to cardiovascular disease Biological determinants Some biological risk factors can increase the chances of cardiovascular disease and some occur as a result of it. The biological risk factors for cardiovascular disease include: • Being overweight and obese. Increased body weight usually places greater strain on the heart. There is also an increased risk of high levels of cholesterol in the blood and a higher risk of hypertension. • Having high blood pressure, which is an indicator that the heart is already working harder to pump the blood • Having high blood cholesterol, which increases the risk of plaque building up on artery walls (atherosclerosis), making it harder for the blood to get through • Having a genetic predisposition. Having family members (particularly in the immediate family) with cardiovascular disease increases the risk of cardio vascular disease. • Being male. Men carry more fat around the abdomen, which places them at increased risk of cardiovascular disease. • Hormones. Testosterone may decrease the risk of cardiovascular disease and oestrogen may also play a protective role (although the results from studies researching this are inconclusive at the time of writing). • Advancing age. Basal metabolism slows as people age, making weight management more difficult. The heart also loses its efficiency as people age, contributing to cardiovascular disease. Behavioural determinants There are many behavioural determinants that increase an individual’s risk of developing cardiovascular disease. Therefore many opportunities exist to prevent cardiovascular disease. The behavioural determinants that increase the risk of developing cardiovascular disease include: • Tobacco smoking, which increases blood pressure and contributes to plaque building up on artery walls • Excessive alcohol consumption. Alcohol contains a lot of kilojoules. If these kilojoules are not used, then it increases the chance of becoming overweight or obese, increasing the risk of cardiovascular disease. • Insufficient physical activity. Not being active enough causes unused energy to be stored as fat, contributing to overweight or obesity. Like all muscles, the heart must be trained and worked if it is to maintain its strength and efficiency. • Poor nutrition. A diet high in saturated and trans fats increases the risk of obesity. Not eating enough fruit and vegetables may also put people at an elevated risk of cardiovascular disease, as the nutrients in these foods may act to reduce the risk of cardiovascular disease. People eating fruit and vegetables are also less likely to snack on energy dense alternatives. Social determinants It is difficult to identify the exact causal relationship between cardiovascular diseases and the social determinants of health. There are, however, definite correlations between certain social determinants and cardiovascular disease rates. They include: • Socioeconomic status. People in lower socioeconomic status groups are more likely to be obese and are therefore more likely to suffer from CVD. People from low socioeconomic groups also have higher rates of smoking. • Social exclusion, which leads to a disadvantaged lifestyle (Low socioeconomic status), which increases the risk of CVD. Socially excluded people may also be more likely to smoke and consume excessive amounts of alcohol, which both increase the risk of cardiovascular disease. • Unemployment. Unemployed people have higher risks of CVD. This may be attributable to high stress levels and reduced socioeconomic status. • Work. Job control has a relationship with CVD (see figure 4.18). People experiencing high levels of stress are at an increased risk of cardiovascular disease. Some jobs involve more physical activity and may assist with weight management, therefore reducing the risks of developing CVD. • Food security. If individuals can either not afford or access a healthy food supply, they may rely on processed food items, which can contain high levels of fat, sugar and salt, all of which contribute to cardiovascular disease. • Transport. People who choose passive modes of transport, such as car or train travel, may burn less energy and therefore be at higher risk of becoming overweight or obese, increasing the risk of CVD. • Stress. Long periods of stress produce physical changes that include an increased risk of heart attack and high blood pressure. • Early life experiences. Good diet and exercise practices can mean optimal weight during the early years of life. People with a healthy weight in childhood are more likely to have a healthy weight in later life. Habits learned in early life may also be carried through to the later years. The prenatal environment can increase risk.